1.Choice for the treatment of Monteggia′s fracture in children
Ke SUN ; Shengping TANG ; Jianglong XU
Orthopedic Journal of China 2006;0(08):-
[Objective]To discuss the clinical results and treatments of the Monteggia's fracture in children.[Method]Total of 66 patients including 61 fresh and 5 old fractures were reviewed.There were 47 males and 19 females.According to the Bado classification system: 46 of type Ⅰ,4 of type Ⅱ,15 of type Ⅲ,1 of type Ⅳ,all patients received conservative or operatire treatment.The conservatively treated patients received manipulation and plaster immobilization.In the operative group,the patients were fixed with single or/and double Kirschner's wires after reduction of the radiohumeral joints or/and fractured ulna.Neither reparation nor reconstruction was needed.[Result]All patients were available at the final follow up with 0.5~5 years.According to the Li Hanmin's scoring system for the motion function in children: excellent and good rate was 95.7% in conservative group and 84.2% in operative group.There was no complication such as myositis ossificans,synostosis of radius and ulna,ulna nonunion,radial head dislocation and profundus radial nerve injury.The cases of nerve injury were complete recovered after operation two or four months later.[Conclusion]The clinical results of the Monteggia's fracture in children was very good with immediate reduction and internal fixation in proper cases,a good overall therapeutic outcome can be expected in children with Monteggia's fracture.It is very important to prevent missed diagnosis.
2.Robot-assisted total knee arthroplasty research on safety and effectiveness
Luqiao PU ; Tao YE ; Longjun SHU ; Ying GUO ; Jinhong ZHANG ; Guangmin PU ; Jianglong TANG ; Xuhan MENG ; Zhifang TANG ; Pengfei BU ; Yongqing XU ; Chuan LI
Chinese Journal of Orthopaedics 2023;43(1):31-40
Objective:To investigate the safety and effectiveness of robot-assisted total knee arthroplasty (TKA).Methods:From August 2021 to March 2022, the data of 69 patients who received robot-assisted TKA for inflammatory disease of knee in 6 hospitals were collected, including 24 males and 45 females, aged 52±6 years (range, 46-72 years), including 53 cases of knee osteoarthritis,10 cases of rheumatoid arthritis, and 6 cases of traumatic arthritis. Imaging data examination of patients was completed according to the multicenter specification. Preoperatively, the patient's CT data were extracted before surgery and a personalized prosthesis positioning plan was designed by the robotic system to determine the prosthesis size, lower limb force lines, and femoral and tibial osteotomy volumes; intraoperatively, the osteotomy template was robotically controlled to complete the osteotomy according to the prosthesis positioning plan, and the intraoperative osteotomy volumes were measured to verify the accuracy of the robot-assisted TKA osteotomy with the preoperative planning. Postoperatively, the lateral angle of the distal femur, the medial angle of the proximal tibia and the hip-knee-ankle angle were measured in the coronal plane according to radiographs; the postoperative outcome was evaluated 3 months after operation, using the American Knee Society score (KSS), including the KSS knee score and functional score.Results:The operative time was 97.3±2.3 min (range, 80-110 min) and the amount of bleeding was 320.0±6.2 ml (range, 300-350 ml) in 69 patients. Three months after operation, the mean range of motion of knee joint was increased from 82.2°±1.1° before surgery to 119.7°±0.8° after surgery ( t=27.65, P<0.001), and the line of force of lower limb was improved from 160.9°±0.5° before surgery to 178.0°±0.2° after surgery ( t=32.03, P<0.001). KSS-knee score increased from 54.8±0.7 points before operation to 85.0±0.5 points after operation, and KSS-functional score increased from 56.5±0.7 points before operation to 85.9±0.4 points after operation, the difference was statistically significant ( t=35.45, 36.58, P<0.001). The proportion of patients with intraoperative femoral and tibial osteotomies within 2 mm osteotomy error compared with preoperative planning was 97% for the lateral tibial plateau, 100% for the medial tibial plateau, 100% for the lateral distal femur, 99% for the medial distal femur, 93% for the lateral posterior femoral condyle, and 100% for the medial posterior femoral condyle; The proportion of patients with postoperative anteroposterior X-ray measurement angle error within 3° was: 100.0% for the distal lateral femoral angle, 100.0% for the proximal medial tibial angle, and 100% for the hip-knee-ankle angle. No complications occurred in all patients except for one case in which fat liquefaction occurred in the postoperative wound. Conclusion:Robot-assisted TKA is a safe and effective surgical method for the treatment of inflammatory disease of knee with accurate prosthesis installation and good postoperative recovery of lower limb alignment.
3.Study on Repairing Effect of Kangfuxin Liquid on Cartilage Defect of Knee Osteoarthritis Model Rabbits and Its Mechanisms
Tao WANG ; Ying GUO ; Hong YIN ; Xiaoxia TANG ; Jianglong LIAO ; Wenze HUANG ; Yanfei XU ; Yuanliang AI ; Jinlei LI ; Hui WEN ; Jingfan YANG
China Pharmacy 2019;30(2):197-201
OBJECTIVE: To investigate the effects of Kangfuxin liquid on repairing cartilage defect model of knee osteoarthritis (KOA) in rabbits and its mechanism. METHODS: Totally 72 male New Zealand rabbits were selected and randomly divided into model control group and Kangfuxin low-dose, medium-dose, high-dose groups, with 18 rabbits in each group. A cartilage defect model of the medial femoral condyle of the right knee joint in rabbits was established by drilling after anesthesia surgery. Then the rabbits in each group were given medicine via articular cavity immediately. Kangfuxin low-dose, middle-dose and high-dose groups were given 20%, 40%, 80% Kangfuxin liquid; model control group was given constant volume of normal saline consecutively, 0.2 mL/kg, once every 3 days. At 4th, 8th, 12th week after medication, the wound repair of cartilage defect in rabbits was observed. Immediately after medication and at 4th, 8th, 12th week after medication, repaired tissue of cartilage defect in rabbits was scored histologically with Wakitani scoring standard under light microscope. At 12th week after medication, pathological changes of repaired tissue of cartilage defect in rabbits were observed by Masson staining. The levels of NO, SOD and LPO in joint fluid and PYD in urine of rabbits were detected by ELISA. RESULTS: At 4th, 8th, 12th week after medication, compared with model control group, cartilage defects in rabbits were repaired well in Kangfuxin low-dose, medium-dose and high-dose groups. At 4th, 8th, 12th week after medication, compared with immediately after medication and model control group at same time point, histomorphological score of repairing cartilage defect of knee joint in rabbits decreased significantly in Kangfuxin low-dose, medium-dose and high-dose groups (P<0.05). At 12th week after medication, compared with model control group, the histopathology degree of cartilage defect of knee joint in rabbits was significantly alleviated in Kangfuxin low-dose, medium-dose and high-dose groups. At 4th, 8th, 12th week after medication, compared with model control group, the levels of NO and LPO in joint fluid and PYD level in urine were decreased to different extent in Kangfuxin low-dose, medium-dose and high-dose groups, while SOD level was increased to different extent; at 12th week after medication, the difference of each index has statistical significance (P<0.05 or P<0.01). CONCLUSIONS: Kangangxin liquid can significantly repair cartilage defect of KOA cartilage defect model rabbits, the mechanism of which may be associated with increasing the expression of SOD and mediating NO-inhibited chondrocyte apoptosis.